17 May Research Healthcare DATA & CLAIMS
Research healthcare data and claims. Discuss two types of third party plans and what information is required on a claim being submitted to them. Outline the steps for filing a claim. Discuss the requirements for a managed care patient referral. Describe the process for verification of eligibility of services, precertification and preauthorization. In addition, define a patient-centered medical home.
Provide an example either real or fictional of situation when a patient would be directly or indirectly involved in providing the data for one of your examples. In the example, be sure to incorporate the pertinent terms that were discussed/defined above.
Your response should be 3-5 paragraphs in length. Follow APA formatting as appropriate.
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